WO2002038163A1 - Mastic osseux et son procede - Google Patents
Mastic osseux et son procede Download PDFInfo
- Publication number
- WO2002038163A1 WO2002038163A1 PCT/US2001/044848 US0144848W WO0238163A1 WO 2002038163 A1 WO2002038163 A1 WO 2002038163A1 US 0144848 W US0144848 W US 0144848W WO 0238163 A1 WO0238163 A1 WO 0238163A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- bone
- water
- demineralized
- supernatant
- gel
- Prior art date
Links
- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 114
- 238000000034 method Methods 0.000 title claims abstract description 29
- 239000006228 supernatant Substances 0.000 claims abstract description 32
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 31
- 239000002245 particle Substances 0.000 claims abstract description 22
- 239000000463 material Substances 0.000 claims abstract description 12
- 239000000725 suspension Substances 0.000 claims abstract description 12
- 210000002805 bone matrix Anatomy 0.000 claims abstract description 11
- 238000013019 agitation Methods 0.000 claims abstract description 5
- 210000002966 serum Anatomy 0.000 claims abstract description 5
- 239000000203 mixture Substances 0.000 claims description 22
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims description 9
- 235000002639 sodium chloride Nutrition 0.000 claims description 5
- 239000011780 sodium chloride Substances 0.000 claims description 4
- LWIHDJKSTIGBAC-UHFFFAOYSA-K tripotassium phosphate Chemical compound [K+].[K+].[K+].[O-]P([O-])([O-])=O LWIHDJKSTIGBAC-UHFFFAOYSA-K 0.000 claims description 4
- 229910000160 potassium phosphate Inorganic materials 0.000 claims description 2
- 235000011009 potassium phosphates Nutrition 0.000 claims description 2
- UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 claims 2
- 238000001816 cooling Methods 0.000 claims 2
- 150000003839 salts Chemical class 0.000 claims 1
- 235000017557 sodium bicarbonate Nutrition 0.000 claims 1
- 229910000030 sodium bicarbonate Inorganic materials 0.000 claims 1
- 238000004090 dissolution Methods 0.000 abstract description 5
- 238000002604 ultrasonography Methods 0.000 abstract description 4
- 238000002360 preparation method Methods 0.000 abstract 1
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 description 36
- 239000000843 powder Substances 0.000 description 24
- 239000000499 gel Substances 0.000 description 21
- 210000004369 blood Anatomy 0.000 description 12
- 239000008280 blood Substances 0.000 description 12
- 230000007547 defect Effects 0.000 description 11
- 239000000243 solution Substances 0.000 description 8
- 210000001519 tissue Anatomy 0.000 description 7
- 241000283690 Bos taurus Species 0.000 description 6
- 102000008186 Collagen Human genes 0.000 description 6
- 108010035532 Collagen Proteins 0.000 description 6
- 229920001436 collagen Polymers 0.000 description 6
- 238000004519 manufacturing process Methods 0.000 description 6
- 238000009835 boiling Methods 0.000 description 4
- 201000010099 disease Diseases 0.000 description 4
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 4
- 150000004676 glycans Chemical class 0.000 description 4
- 229920001282 polysaccharide Polymers 0.000 description 4
- 239000005017 polysaccharide Substances 0.000 description 4
- 229920002683 Glycosaminoglycan Polymers 0.000 description 3
- 239000011575 calcium Substances 0.000 description 3
- 229910052791 calcium Inorganic materials 0.000 description 3
- 150000001875 compounds Chemical class 0.000 description 3
- 230000035876 healing Effects 0.000 description 3
- 150000002772 monosaccharides Chemical class 0.000 description 3
- OYPRJOBELJOOCE-UHFFFAOYSA-N Calcium Chemical compound [Ca] OYPRJOBELJOOCE-UHFFFAOYSA-N 0.000 description 2
- 241001465754 Metazoa Species 0.000 description 2
- 239000002639 bone cement Substances 0.000 description 2
- 230000008468 bone growth Effects 0.000 description 2
- 229940036811 bone meal Drugs 0.000 description 2
- 239000002374 bone meal Substances 0.000 description 2
- 230000007812 deficiency Effects 0.000 description 2
- 239000012153 distilled water Substances 0.000 description 2
- 230000009969 flowable effect Effects 0.000 description 2
- 230000012010 growth Effects 0.000 description 2
- 238000010438 heat treatment Methods 0.000 description 2
- -1 hydrogen ions Chemical class 0.000 description 2
- 230000001939 inductive effect Effects 0.000 description 2
- 238000003760 magnetic stirring Methods 0.000 description 2
- 230000000921 morphogenic effect Effects 0.000 description 2
- 102000004169 proteins and genes Human genes 0.000 description 2
- 108090000623 proteins and genes Proteins 0.000 description 2
- KIUKXJAPPMFGSW-DNGZLQJQSA-N (2S,3S,4S,5R,6R)-6-[(2S,3R,4R,5S,6R)-3-Acetamido-2-[(2S,3S,4R,5R,6R)-6-[(2R,3R,4R,5S,6R)-3-acetamido-2,5-dihydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-2-carboxy-4,5-dihydroxyoxan-3-yl]oxy-5-hydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-3,4,5-trihydroxyoxane-2-carboxylic acid Chemical compound CC(=O)N[C@H]1[C@H](O)O[C@H](CO)[C@@H](O)[C@@H]1O[C@H]1[C@H](O)[C@@H](O)[C@H](O[C@H]2[C@@H]([C@@H](O[C@H]3[C@@H]([C@@H](O)[C@H](O)[C@H](O3)C(O)=O)O)[C@H](O)[C@@H](CO)O2)NC(C)=O)[C@@H](C(O)=O)O1 KIUKXJAPPMFGSW-DNGZLQJQSA-N 0.000 description 1
- MSWZFWKMSRAUBD-IVMDWMLBSA-N 2-amino-2-deoxy-D-glucopyranose Chemical compound N[C@H]1C(O)O[C@H](CO)[C@@H](O)[C@@H]1O MSWZFWKMSRAUBD-IVMDWMLBSA-N 0.000 description 1
- 208000014644 Brain disease Diseases 0.000 description 1
- 229920001661 Chitosan Polymers 0.000 description 1
- 208000032274 Encephalopathy Diseases 0.000 description 1
- IAJILQKETJEXLJ-UHFFFAOYSA-N Galacturonsaeure Natural products O=CC(O)C(O)C(O)C(O)C(O)=O IAJILQKETJEXLJ-UHFFFAOYSA-N 0.000 description 1
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 1
- 241000282412 Homo Species 0.000 description 1
- UIIMBOGNXHQVGW-DEQYMQKBSA-M Sodium bicarbonate-14C Chemical compound [Na+].O[14C]([O-])=O UIIMBOGNXHQVGW-DEQYMQKBSA-M 0.000 description 1
- 229920002385 Sodium hyaluronate Polymers 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- IAJILQKETJEXLJ-QTBDOELSSA-N aldehydo-D-glucuronic acid Chemical compound O=C[C@H](O)[C@@H](O)[C@H](O)[C@H](O)C(O)=O IAJILQKETJEXLJ-QTBDOELSSA-N 0.000 description 1
- 239000003855 balanced salt solution Substances 0.000 description 1
- MSWZFWKMSRAUBD-UHFFFAOYSA-N beta-D-galactosamine Natural products NC1C(O)OC(CO)C(O)C1O MSWZFWKMSRAUBD-UHFFFAOYSA-N 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 210000001124 body fluid Anatomy 0.000 description 1
- 239000010839 body fluid Substances 0.000 description 1
- 230000036760 body temperature Effects 0.000 description 1
- 230000001010 compromised effect Effects 0.000 description 1
- 238000004132 cross linking Methods 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 150000002016 disaccharides Chemical class 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 239000000945 filler Substances 0.000 description 1
- 239000012467 final product Substances 0.000 description 1
- 238000009472 formulation Methods 0.000 description 1
- 239000012634 fragment Substances 0.000 description 1
- 229960002442 glucosamine Drugs 0.000 description 1
- 239000008103 glucose Substances 0.000 description 1
- 229940097043 glucuronic acid Drugs 0.000 description 1
- 239000001963 growth medium Substances 0.000 description 1
- 150000002402 hexoses Chemical class 0.000 description 1
- 229920002674 hyaluronan Polymers 0.000 description 1
- 229960003160 hyaluronic acid Drugs 0.000 description 1
- 230000036571 hydration Effects 0.000 description 1
- 238000006703 hydration reaction Methods 0.000 description 1
- 239000000017 hydrogel Substances 0.000 description 1
- 229910052739 hydrogen Inorganic materials 0.000 description 1
- 239000001257 hydrogen Substances 0.000 description 1
- 230000002163 immunogen Effects 0.000 description 1
- 230000009851 immunogenic response Effects 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 230000002757 inflammatory effect Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 230000001057 ionotropic effect Effects 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 230000005541 medical transmission Effects 0.000 description 1
- 229910021645 metal ion Inorganic materials 0.000 description 1
- 238000003801 milling Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 231100000189 neurotoxic Toxicity 0.000 description 1
- 230000002887 neurotoxic effect Effects 0.000 description 1
- 231100000252 nontoxic Toxicity 0.000 description 1
- 230000003000 nontoxic effect Effects 0.000 description 1
- 229920001542 oligosaccharide Polymers 0.000 description 1
- 150000002482 oligosaccharides Chemical class 0.000 description 1
- 239000003960 organic solvent Substances 0.000 description 1
- 230000011164 ossification Effects 0.000 description 1
- 230000002188 osteogenic effect Effects 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 239000008363 phosphate buffer Substances 0.000 description 1
- 239000000047 product Substances 0.000 description 1
- 231100000241 scar Toxicity 0.000 description 1
- 229940010747 sodium hyaluronate Drugs 0.000 description 1
- 239000012064 sodium phosphate buffer Substances 0.000 description 1
- YWIVKILSMZOHHF-QJZPQSOGSA-N sodium;(2s,3s,4s,5r,6r)-6-[(2s,3r,4r,5s,6r)-3-acetamido-2-[(2s,3s,4r,5r,6r)-6-[(2r,3r,4r,5s,6r)-3-acetamido-2,5-dihydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-2-carboxy-4,5-dihydroxyoxan-3-yl]oxy-5-hydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-3,4,5-trihydroxyoxane-2- Chemical compound [Na+].CC(=O)N[C@H]1[C@H](O)O[C@H](CO)[C@@H](O)[C@@H]1O[C@H]1[C@H](O)[C@@H](O)[C@H](O[C@H]2[C@@H]([C@@H](O[C@H]3[C@@H]([C@@H](O)[C@H](O)[C@H](O3)C(O)=O)O)[C@H](O)[C@@H](CO)O2)NC(C)=O)[C@@H](C(O)=O)O1 YWIVKILSMZOHHF-QJZPQSOGSA-N 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- 239000008227 sterile water for injection Substances 0.000 description 1
- 238000011477 surgical intervention Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 231100000331 toxic Toxicity 0.000 description 1
- 230000002588 toxic effect Effects 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 230000029663 wound healing Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3683—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment
- A61L27/3691—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment characterised by physical conditions of the treatment, e.g. applying a compressive force to the composition, pressure cycles, ultrasonic/sonication or microwave treatment, lyophilisation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
- A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
- A61K35/32—Bones; Osteocytes; Osteoblasts; Tendons; Tenocytes; Teeth; Odontoblasts; Cartilage; Chondrocytes; Synovial membrane
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/0005—Ingredients of undetermined constitution or reaction products thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3604—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
- A61L27/3608—Bone, e.g. demineralised bone matrix [DBM], bone powder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3683—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools for implanting artificial joints
- A61F2/4644—Preparation of bone graft, bone plugs or bone dowels, e.g. grinding or milling bone material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30059—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in bone mineralization, e.g. made from both mineralized and demineralized adjacent parts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants
Definitions
- This invention pertains to a bone matrix suspension in forms suitable for surgical grafting or other medical uses and a method for making same.
- Malleable bone putty or bone gel is used to correct surgical defects that may be caused by trauma, pathological disease, surgical intervention or other situations where defects need to be managed in osseous surgery. It is important to have the defect filler in the form of a stable, viscous gel or putty to facilitate the placement of the bone growth medium into the surgical site which is usually uneven in shape and depth. The surgeon will take the gel or putty on a spatula or other instrument and trowel it into the site or take it in his/her fingers to shape the bone inducing material into the proper configuration to fit the site being corrected.
- Specific monosaccharides in blood are glucose at a concentration of 60- 100 mg/ 100 ml (0.1 %) and polysaccharides such as hexose and glucosamine at approximately 0.1%.
- Glucuronic acid is also present at approximately 0.4-1.4 mg/100 ml (average 0.01%).
- the problems inherent with using the patient's blood as a carrier for demineralized bone powder are the difficulties of mixing the same at the operating site, the difficulty in obtaining a bone paste consistency which can be easily applied to the surgical area, the guesswork in mixing a usable composition at the site and the problem of having a bone paste or gel which will promote optimum bone replacement growth and not be carried away by the body fluids at the operation site or simply fall out of the bone defect site.
- Demineralized allograft bone matrix (DBM) is produced from banked human bone taken from cadavers.
- Demineralized allograft bone is usually available in a lyophilized or freeze dried and sterile form - such as cubes, shavings, or powder - to provide for extended shelf life.
- the bone in this form is usually very coarse and dry and is difficult to manipulate by the surgeon.
- GRAFTON® a registered trademark of Osteotech Inc.
- GRAFTON® a registered trademark of Osteotech Inc.
- GRAFTON® works well to allow the surgeon to place the allograft bone material at the site.
- the carrier, glycerol has a very low molecular weight (92 Daltons) and is very soluble in water - the primary component of the blood which flows at the surgical site.
- Glycerol also experiences a marked reduction in viscosity when its temperature rises from room temperature (typically 22° C in an operating room) to the temperature of the patient's tissue, typically 37° C. This combination of high water solubility and reduced viscosity causes the allograft bone material to be "runny" and to flow away from the site almost immediately after placement; this prevents the proper retention of the bone within the site as carefully placed by the surgeon.
- GRAFTON® gel have been attempted to be resolved by using a much larger particle size of allograft bone, specifically lamellae or slivers of bone created by milling or slicing the bone before mixing it with the glycerol carrier.
- the larger particles of demineralized bone may also retard the development of new bone by the patient because the large bony lamellae do not pack as well as the smaller grainy particles of bone. This will leave more open space and could lengthen the tine required to grow new bone and properly fill the defect.
- Another deficiency of using the bony lamellae is that the ends of the bony fragments are uneven and when packed into the surgical defect, leave uneven filaments of bone protruding out from the defect which can compromise the healing rate.
- U.S. Patent No. 5,290,558 discloses a flowable demineralized bone powder composition using a osteogenic bone powder with a large particle size ranging from about 0.1 to about 1.2 cm, mixed with a low molecular weight polyhydroxy compound possessing from 2 to about 18 carbons including a number of classes of different compounds such as monosaccharides, disaccharides, water dispersible oligosaccharides and polysaccharides.
- No. 4,172,1208 which discloses demineralized bone material mixed with a carrier used to reconstruct tooth or bone material, and made by adding a mucopolysaccharide to a mineralized bone colloidal material.
- the composition is formed from a demineralized coarsely ground bone material, which may be derived from human bones and teeth, dissolved in a solvent forming a colloidal solution to which is added a physiologically inert polyhydroxy compound such as mucopolysaccharide or polyuronic acid in an amount which causes orientation when hydrogen ions or polyvalent metal ions are added to form a gel.
- the gel will be flowable at elevated temperatures above 35°C and will solidify when brought down to body temperature.
- Example 25 of the patent notes that mucopolysaccharides produce pronounced ionotropic effects and that hyaluronic acid is particularly responsible for spatial cross-linking. Unfortunately this bone gel is difficult to manufacture and requires a pre-molded gel form.
- U.S. Patent No. 4,191,747 teaches a bone defect treatment with coarsely ground, denatured bone meal freed from fat and ground into powder.
- the bone meal is mixed with a polysaccharide in a solution of saline and applied to the bone defect site.
- Another prior art product is the formulation of demineralized allograft bone particles in collagen.
- Bovine collagen carries the risk of an immunogenic reaction by the recipient patient.
- BSE bovine spongioform encephalopathy
- bovine tissue carries a risk of disease transmission and is not a desirable carrier for allograft tissue.
- Human collagen is free of these animal based diseases. However, collagen absorbs slowly in the human body, particularly in a bony site with usually a low degree of vascularity. The slow absorption of collagen can delay the growth of new bone and result in the formation of scar tissue at the site. This could result in a non-bony healing and a result with much less tensile strength.
- U.S. Patent No. 6,030,635 describes a method for making a bone putty or gel in which bone powder is suspended in a carrier that is selected from the group consisting of sodium hyaluronate, chitosan and N,O-carboxymethylchitosan, in water solution.
- a carrier selected from the group consisting of sodium hyaluronate, chitosan and N,O-carboxymethylchitosan, in water solution.
- the use of other hydrogels is also disclosed.
- a disadvantage of such a composition is that it employs as a carrier synthetic components that may not be well tolerated in vivo. Accordingly, the prior art as embodied in the glycerol and other carrier based technology to deliver demineralized allograft bone to a surgical osseous site is replete with problems and only partially addresses the problems inherent in the correcting surgical defects. A need exists for a bone gel or putty free from the disadvantages of the prior art.
- a bone gel or putty has been discovered that uses aqueous dissolved demineralized bone as the carrier in which bone particles are suspended.
- the carrier may also comprise additional components such as those normally found in blood serum.
- the carrier is non-toxic and does not adversely impact the patient.
- the present invention also provides an easy method for the production of bone gel or bone putty that is biocompatible, non-inflammatory, capable of inducing
- the aforementioned gel or putty can be made extremely malleable while retaining its structural and dimensional integrity both prior to and after hydration and additionally possessing significant tensile strength.
- the aqueous dissolved demineralized bone used as the carrier may be formed in any advantageous manner.
- a supernatant may be formed by dissolving demineralized allograft bone matrix, in the form of cubes, shavings, or powders, in either water or a solution comprising water and at least one component normally found in animal blood serum (e.g., sodium chloride, potassium phosphate, sodium bicarbonate, or the like) at a temperature of above about 25° C.
- animal blood serum e.g., sodium chloride, potassium phosphate, sodium bicarbonate, or the like
- dissolution is enhanced by the use of agitation and/or ultrasound.
- the dissolution may also be enhanced by use of pressure.
- the pressure will be at least about 15 psi, for a period of time.
- the resulting viscous supernatant is then cooled and mixed with demineralized or non-demineralized bone powder or shavings to form a gel-like or putty-like suspension.
- the supernatant is obtained by heating to a temperature between about 85° C and about 100° C.
- a viscous supernatant is formed from the demineralized bone.
- the bone dissolution is continued under the elevated temperature for a period of time sufficient to generate a supernatant having a viscosity above about 1 centipoise; more particularly, the heating is continued to the point where a thick, viscous liquid has been formed, which usually takes place between about 24 and about 120 hours.
- the supernatant is then allowed to cool.
- the heated solution is subjected to an elevated pressure of at least about 15 psi, more preferably between about 15 psi and about 90 psi, the bone is dissolved more readily.
- the use of pressure to dissolve the demineralized bone matrix is faster, in that the process, depending on the amount of pressure used, usually only needs to be carried out from between about 1 hour to about 8 hours.
- the further advantage lies in that there may not need to be any mechanical agitation, as the elevated pressure compensates for this.
- the supernatant is then cooled. Once cooled, the viscous supernatant is mixed with either demineralized or non-demineralized bone powder or shavings. As this is done, the mixture will achieve, at first, a gel-like texture. At this point, a bone gel has been formed from the mixture of a supernatant with suspended demineralized bone particles and demineralized or non-demineralized bone powder or shavings. However, more demineralized or non-demineralized bone powder or shavings may be added in order to achieve a putty-like texture. Usually the amount of dissolved demineralized bone will be from about 0.5 to about 25 percent, by weight, based on the total weight of water and bone, preferably from about 5 to about 10 percent.
- the demineralized bone used to make the carrier may be in any physical form, such as chips, shavings or particles.
- the form of the demineralized bone used to make the carrier is not critical, as it ultimately will be dissolved. The use of smaller particles will aid in the dissolution process.
- Sufficient demineralized bone is dissolved to increase the viscosity of the water. Preferably the viscosity is increased to from about 2 to about 100 centipoises, preferably from about 40 to about 200 centipoises. Alternatively sufficient demineralized bone is dissolved to convert the carrier into a gel or gel-like structure.
- the water may be sterile water for injection or sterile saline solution or may comprise other components, such as those normally found in blood, such as BSS balanced salt solution, containing 140 mM NaCl, 5.4 mM KC1, at a pH of 7.6.
- Soluble calcium can be attracted to the surgical site by using a sodium phosphate buffer of pH 7.2 in lieu of the isotonic saline.
- the phosphate buffer will attract calcium cations to the site from the surrounding healthy bone and create an equilibrium concentration of the calcium precisely at the site of healing where it is most desirable to grow new bone.
- bone powder or shavings are added to form a gel-like or putty-like suspension.
- the bone that is added may be demineralized or non- demineralized bone , or a mixture thereof, and may be in the physical form of chips, shavings or powder.
- the bone has an average particle size of from about 10 to about 850 microns, more preferably from about 250-500 microns.
- the amount of suspended bone that is present in the final product usually will be from about 5 to about 50 percent by weight, based on the total weight of the suspension, preferably from about 7 to about 30 percent, and most preferably from about 10 to about 20 percent.
- EXAMPLE 1 This example demonstrates a novel method of making a bone gel with a useful bulk viscosity and optimum bioabsorbability.
- Demineralized bone powder with particle size of 45-125 ⁇ m is placed in distilled water boiling at 100° C.
- the solution is constantly agitated by magnetic stirring and/or ultrasound for 72 hours, at which point a viscous supernatant has been produced.
- the supernatant is then set out for several hours to cool, and then mixed with demineralized bone powder to form a gel-like suspension.
- EXAMPLE 2 This example demonstrates a novel method of making a bone putty with a useful bulk viscosity and optimum bioabsorbability.
- Demineralized bone powder with particle size of 45-125 ⁇ m is placed in distilled water boiling at 100° C.
- the solution is constantly agitated by magnetic stirring and/or ultrasound for 72 hours, at which point a viscous supernatant has been produced.
- the supernatant is then set out for several hours to cool, and then mixed with demineralized bone shavings to form a putty-like material.
- This example demonstrates a novel method of making a bone gel with a useful bulk viscosity and optimum bioabsorbability.
- Demineralized bone powder with a particle size of 45-125 ⁇ m is placed in distilled boiling water and autoclaved at a temperature of 110-115° C and at a pressure of 20-22 psi for about 3 hours, at which point a viscous supernatant is produced. The supernatant is then set out for several hours to cool, and then mixed with demineralized bone powder to form a gel-like suspension.
- This example demonstrates a novel method of making a bone putty with a useful bulk viscosity and optimum bioabsorbability.
- Demineralized bone powder with a particle size of 45- 125 ⁇ m is placed in distilled boiling water and autoclaved at a temperature of 110-115° C and at a pressure of 20-22 psi for about 3 hours, at which point a viscous supernatant is produced. The supernatant is then set out for several hours to cool, and then mixed with demineralized bone shavings to form a putty-like material.
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- General Health & Medical Sciences (AREA)
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- Chemical Kinetics & Catalysis (AREA)
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Abstract
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP01993469A EP1341545B1 (fr) | 2000-11-13 | 2001-11-01 | Procédé de préparation d'un mastic osseux |
DE60140142T DE60140142D1 (de) | 2000-11-13 | 2001-11-01 | Verfahren zur herstellung eines knochenzements |
AT01993469T ATE444759T1 (de) | 2000-11-13 | 2001-11-01 | Verfahren zur herstellung eines knochenzements |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/711,716 | 2000-11-13 | ||
US09/711,716 US6576249B1 (en) | 2000-11-13 | 2000-11-13 | Bone putty and method |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2002038163A1 true WO2002038163A1 (fr) | 2002-05-16 |
Family
ID=24859218
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2001/044848 WO2002038163A1 (fr) | 2000-11-13 | 2001-11-01 | Mastic osseux et son procede |
Country Status (6)
Country | Link |
---|---|
US (1) | US6576249B1 (fr) |
EP (1) | EP1341545B1 (fr) |
AT (1) | ATE444759T1 (fr) |
DE (1) | DE60140142D1 (fr) |
RU (1) | RU2003117454A (fr) |
WO (1) | WO2002038163A1 (fr) |
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WO2007003324A3 (fr) * | 2005-06-30 | 2007-08-16 | Transtissue Technologies Gmbh | Greffon acellulaire |
EP1891990A3 (fr) * | 2006-04-19 | 2008-04-23 | Biomet Manufacturing Corp. | Composition et appareil pour la réparation osseuse |
EP2144672A1 (fr) * | 2007-05-04 | 2010-01-20 | Perth Bone & Tissue Bank | Procédé et matériau à libération contrôlée pour traiter l'inflammation |
EP2349365A1 (fr) * | 2008-11-04 | 2011-08-03 | Perth Bone & Tissue Bank | Matériau de support pour des cellules ostéogéniques |
CN102232073A (zh) * | 2008-09-16 | 2011-11-02 | 普罗克西梅根有限公司 | 新化合物i |
US8734828B2 (en) | 2006-10-06 | 2014-05-27 | Biotissue Ag | Matrix-gel graft without cells |
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- 2001-11-01 EP EP01993469A patent/EP1341545B1/fr not_active Expired - Lifetime
- 2001-11-01 AT AT01993469T patent/ATE444759T1/de not_active IP Right Cessation
- 2001-11-01 RU RU2003117454/15A patent/RU2003117454A/ru not_active Application Discontinuation
- 2001-11-01 DE DE60140142T patent/DE60140142D1/de not_active Expired - Fee Related
- 2001-11-01 WO PCT/US2001/044848 patent/WO2002038163A1/fr active Application Filing
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Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2007003324A3 (fr) * | 2005-06-30 | 2007-08-16 | Transtissue Technologies Gmbh | Greffon acellulaire |
US9125871B2 (en) | 2005-06-30 | 2015-09-08 | Biotissue Ag | Cell-free graft |
EP1891990A3 (fr) * | 2006-04-19 | 2008-04-23 | Biomet Manufacturing Corp. | Composition et appareil pour la réparation osseuse |
US8734828B2 (en) | 2006-10-06 | 2014-05-27 | Biotissue Ag | Matrix-gel graft without cells |
EP2144672A1 (fr) * | 2007-05-04 | 2010-01-20 | Perth Bone & Tissue Bank | Procédé et matériau à libération contrôlée pour traiter l'inflammation |
EP2144672A4 (fr) * | 2007-05-04 | 2012-08-08 | Perth Bone & Tissue Bank | Procédé et matériau à libération contrôlée pour traiter l'inflammation |
CN102232073A (zh) * | 2008-09-16 | 2011-11-02 | 普罗克西梅根有限公司 | 新化合物i |
EP2349365A1 (fr) * | 2008-11-04 | 2011-08-03 | Perth Bone & Tissue Bank | Matériau de support pour des cellules ostéogéniques |
EP2349365A4 (fr) * | 2008-11-04 | 2013-01-23 | Perth Bone & Tissue Bank | Matériau de support pour des cellules ostéogéniques |
Also Published As
Publication number | Publication date |
---|---|
DE60140142D1 (de) | 2009-11-19 |
US6576249B1 (en) | 2003-06-10 |
RU2003117454A (ru) | 2004-11-27 |
EP1341545A4 (fr) | 2004-08-11 |
EP1341545B1 (fr) | 2009-10-07 |
EP1341545A1 (fr) | 2003-09-10 |
ATE444759T1 (de) | 2009-10-15 |
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